Assessment of vascularity in breast carcinoma by computer-assisted video analysis (CAVA) and its association with axillary lymph node status

Case-control methodology was used to evaluate the significance of vascularity in small breast carcinomas with regard to the presence or absence of axillary lymph node metastases. Vascularity was assessed in 32 axillary node positive primary breast tumours (LN+ve) less than 2 cm in size and compared with 56 control axillary node negative primary tumours (LN–ve), which were matched for histological type and grade and tumour size. This study design employed computer-assisted video analysis (CAVA) to assess the total blood vessel perimeter (BVP), total blood vessel area (BVA), and total blood vessel density (BVD) throughout a tissue section that encompassed an entire cross section of the tumour and its immediate periphery. The BVA and BVD in these tumours were not significantly different between LN+ve and LN–ve groups. The LN–ve carcinomas had, on average, a significantly (P < 0.05) higher total BVP (3355 µm/mm²) than LN+ve tumours (2771 µm/mm²). 'Hot spot' areas were also independently assessed by two pathologists and the same areas measured by CAVA. A strong correlation (P < 0.001) between the two methods of assessment of BVD of the neovascular 'hot spots' was found; however, no association with axillary lymph node metastasis was found using either method of assessment. In conclusion, vascularity assessed by either blood vessel density or blood vessel size in primary invasive breast cancers less than 2 cm in diameter showed no association with axillary lymph node metastasis; in fact a negative association was found with total BVP of whole tumour sections and BVD in 'hot spots' using CAVA. Further, this study has established a computer-assisted method of quantifying vascularity in solid neoplasms and is a positive step towards a standardised approach to this diverse and methodologically variable area.     

Prevention of Problem Gambling: Modifying Misconceptions and Increasing Knowledge Among Canadian Youths

Research on gambling demonstrates that youths are involved in gambling activities. As they take part in these activities, young people develop and maintain irrational thoughts about gambling and become at risk for developing severe gambling problems. In a previous study, a French video was designed specifically to correct misconceptions and increase knowledge about gambling (Ferland, Ladouceur, & Vitaro, 2002). Findings indicated that the video significantly improves subjects' knowledge about gambling and corrects their misconceptions. The present study aims to evaluate the effectiveness of the English version of that video. The sample comprised 506 grade 7 and 8 English speaking students from Canada. The results confirmed the efficacy of the video in increasing knowledge of gambling and correcting misconceptions concerning the outcome of these games. The implications of these results for the prevention of gambling problems are discussed.     

医学声像示教实时双向同步传输系统的研制

研制开发病房大楼手术摄像、内窥镜、电子显微镜、病理图像等医学声像信号与科教（培训交流）中心、阶梯教室、示教室、主任办公室等终端医学声像信号的实时双向同步传输示教系统，以弥补PACS系统单向、帧传、滞后的缺陷．为大型学术交流、现场教学示教观摩提供技术支持。     

手术显微镜视频系统

SQL Server2000数据库与VC＋＋6.0软件平台的医用手术显微镜视频专家系统，通过专业医用视频图像采集卡将显微镜视频信号引入计算机，实现手术图像的采集、显示；同时，病历管理系统对采集图像进行编辑、处理、管理、并自动生成病人电子病历，可打印图文兼备的报告单，它可与任何手术显微镜配套使用，实现显微镜手术和病灶诊断2种功能。     

Strategies for Distance Education

Abstract

Advances in and access to technology have loosened academia's ties to the traditional classroom. In this paper we present our experiences in developing, implementing, and evaluating three approaches to distance education. The first program was delivered by interactive videoconferencing and provided multiple gerontological lessons for Extension agents gathered at two different sites in Virginia. The second program was a graduate-level course taught simultaneously at multiple sites also using interactive videoconferencing. The third program was a full-fledged Internet course whose target audience included students enrolled in a gerontology certificate program. The overall strengths of the programs included enhancing the instructors' ability to reach students in a variety of locations without leaving campus and expanding the flexibility and availability of course offerings. The weaknesses and constraints of the various approaches centered on the amount of instructor time necessary to develop and implement the instructional units, technological problems, and student involvement and motivation.     

Video head impulse in comparison to caloric testing in unilateral vestibular schwannoma

Conclusions: Although there was a statistically significant relationship between the results of the vHIT and the caloric test, the limited strength of this relationship suggests that, for unilateral vestibular schwannoma (UVS), caloric testing and vHIT may provide complementary information on vestibular function.

Objective: There is limited information that can be used to determine which of the video head impulse test (vHIT) and caloric test might be better used in the diagnosis and management of UVS. In this study, a group of participants with un-operated UVS was studied using both methods.

Methods: The subjects’ vestibular function was assessed using the vHIT and caloric testing. Tumour size was quantified using MRI and their balance disturbance assessed using the Jacobsen Dizziness Handicap Inventory (DHI).

Results: Twenty of 30 subjects had an abnormal canal paresis according to the Jongkees’ criterion (>?0.25); however, only 10/30 had an ipsilesional vHIT gain of <0.79. Canal paresis could be predicted from the ipsilesional and contralesional vHIT gains. Tumour size could also be predicted from the ipsilesional vHIT gain and canal paresis. However, DHI scores could not be predicted from the degree of canal paresis, vHIT gain, or the MRI measures.     

Comparative study of awake endotracheal intubation with Glidescope video laryngoscope versus flexible fiber optic bronchoscope in patients with traumatic cervical spine injury

BackgroundThe Gldiescope video laryngoscope (GVL) as a recent intubating device has gained much popularity in difficult intubation over the last decade. It can be used as a substitute to flexible fiber optic bronchoscope (FOB) in intubating challenges. The object of this study is to compare the utility of GVL and FOB for intubating time, attempts, effects on hemodynamics, adverse effects, patient satisfaction and post intubation neurological outcome during awake intubation in traumatic cervical spine injury.MethodsFifty patients undergoing post traumatic cervical spine fixation under general anesthesia were randomly allocated to two groups in a prospective, controlled non-blinded study. All patients were premedicated with glycopyrrolate 0.2 mg iv and midazolam 1 mg iv that be repeated up to 0.05 mg/kg followed with a bolus dose of remifentanil 1.5 μg/kg then a continuous remifentanil infusion of 0.15 μg/kg/min for 3 min before procedure. Each patient underwent a wake endotracheal intubation with either GVL (G group) or FOB (F group) with manual in line stabilization (MILS). Intubating time, intubating attempts, hear rate (HR), mean arterial pressure (MAP), oxygen desaturation (SO₂ < 90%), sore throat, patient satisfaction and postintubation neurological outcome were recorded.ResultsIntubating time was significantly lower in G group compared with F group (26 ± 5 versus 72 ± 11 respectively), while the percentage of the first successful intubating attempt was insignificantly higher in G group (88%) than in F group (72%). Both HR and MAP were significantly increased only in F group during intubation in comparison with the basal line values. Both devices were safe for post neurological outcome. No significant differences of adverse effects or patient satisfaction were recorded between groups.ConclusionThe GVL is a safe surrogate for FOB during awake intubation for post traumatic cervical spine fixation.